Alendronate (marketed as Fosamax®), a bisphosphonate drug used to prevent bone loss, has been linked to an increased risk of developing atrial fibrillation, an abnormal heart rhythm that is the leading cause of stroke. In a recent issue of the Archives of Internal Medicine, investigators reported that women who had ever taken alendronate were more likely to develop atrial fibrillation than those who had never taken it, even if they were no longer on the drug.

These findings support the results of a prior study on alendronate, as well as a previous study on zoledronic acid (marketed as Zometa®), another bisphosphonate which has been linked to atrial fibrillation. Bisphosphonate drugs have been shown to prevent bone fractures in people who are at a high risk of fracture, such as post-menopausal women with diabetes or chronic liver or kidney disease. The lead investigator for this study noted that, for these high risk patients, the benefits of fracture prevention with alendronate might outweigh the possible risk of atrial fibrillation.

However, alendronate therapy should be carefully considered for people with a moderate fracture risk, or for people with heart disease or diabetes who are at higher risk for the development of atrial fibrillation. These patients should discuss the relative risks and benefits of bisphosphonate therapy with their physicians.